A Comparison of Functional Outcomes between Patients Admitted to Inpatient Rehabilitation after Initial Diagnosis Versus Recurrence of Glioblastoma Multiforme

Abstract

Background: Prior studies of inpatient rehabilitation of patients with brain tumor demonstrate similar functional gains as compared to other rehabilitation populations. There are few studies specifically examining the rehabilitation of patients with glioblastoma. Objective: To compare functional outcomes between matched patients admitted to acute inpatient rehabilitation after initial diagnosis of glioblastoma (iGBM) and after diagnosis of recurrent glioblastoma (rGBM). Design: A retrospective, case-matched study using descriptive statistics compared demographic information and functional outcomes as designated by the Functional Independence Measure (FIM) score. Setting: A single, freestanding inpatient rehabilitation hospital. Patients: Over a 20-month period, 25 patients with iGBM were matched with 25 patients admitted to an inpatient rehabilitation facility with rGBM by the following criteria: (1) side of lesion (left/right hemisphere), (2) admission total FIM score within 10 points, (3) age within 10 years, and (4) gender. Nineteen of the 25 patients in each group were matched meeting all criteria, and 6 of the 25 patients were matched meeting three out of four criteria. Interventions: Not applicable. Main Outcome Measure: The primary outcome measures were differences in functional outcomes as measured by FIM scores. Results: There were no statistically significant differences (P < .05) between the groups in mean admission FIM scores, discharge FIM scores, FIM gains, and FIM efficiencies. There were no statistically significant differences in the development of complications during acute rehabilitation and transfer rate to acute care hospital. Sixty-four percent of patients in both groups were able to be discharged home. Conclusions: This study demonstrated no statistically significant differences in functional outcomes between matched patients admitted with iGBM compared to rGBM. Further studies are indicated to examine the rehabilitation outcomes of patients with rGBM in inpatient rehabilitation.

Recovery in glioblastoma multiforme during inpatient rehabilitation is equivalent in first versus repeat resection: A 10‐year retrospective analysis

“…Contrary to our hypothesis, our data suggest that GBM patients who have undergone a second resection progress as well as their single resection peers with regard to functional recovery following an IRU course. This is in line with Reilly et al's findings of similar functional outcomes in initial versus recurrent GBM, though, of note, only 60% of their recurrence group had resection before IRU admission 40 . Additionally, we found the gains in those with multiple resections may be achieved over a shorter IRU stay with an equivalent likelihood of being discharged home when compared to those with first resection.…”

“…Broadly, on our unit, we encountered two distinct groups of patients with regards to postoperative steroid administration: one group that was able to complete the regimen prior to discharge and a second group that was discharged still receiving steroids. Reilly et al did note in their study that steroid weaning was more successful in those with initial diagnosis of GBM than those with recurrence 40 . It is feasible that as the steroids are tapered, differences in functional recovery would become apparent between the two groups.…”

“…There are even fewer data on the impact of recurrence on functional outcome during inpatient rehabilitation. Whereas Marciniak and colleagues (analyzing data collected before the Stupp Protocol) found that patients with recurrent tumors made significantly smaller functional motor gains than those with an initial diagnosis, more recently Reilly et al found no significant differences in functional outcomes between matched patients with initial versus recurrent GBM 11,40 …”

Rehabilitation of Adult Patients with Primary Brain Tumors: A Narrative Review

“…Reilly et al compared functional outcomes of 25 patients with initial diagnosis glioblastoma multiforme with 25 demographic-and lesion-matched recurrent glioblastoma multiforme patients and found that there was no statistical difference in functional gains at discharge between the two groups [54]. The full table can be seen in Table 2.…”

“…Reilly et al 2020 [54] Retrospective case matched study comparing 25 patients with an initial diagnosis of glioblastoma multiforme with 25 demographic-and lesion-matched patients who had a diagnosis of recurrent glioblastoma multiforme.…”